Surveillance by casualty attendance registers.

Health managers need trauma data, but appropriate information is often lacking. The challenge is to develop affordable and sustainable information systems. The article describes the development of a regional trauma database and an evaluation of a basic surveillance methodology. A comprehensive survey was conducted of first-time attenders with fatal and nonfatal trauma from both state and private sectors in metropolitan Cape Town, South Africa, and a hospital-based survey was conducted of nonfatal trauma in the surrounding rural areas. In four state hospitals, a standardized adaptation of casualty attendance registers was evaluated to determine whether such registers could be used to establish a trauma surveillance system. The two cross-sectional studies covered a population of 3.4 million and provided detailed data. The evaluation of the register highlighted problems and indicated how to establish a register-based trauma surveillance system. Although such surveys yield comprehensive local data, there is a need for salient regional and national surveillance data. Minor modifications of casualty attendance registers may provide this without much additional effort and expense.